NPI 1235209115

Mississippi Foot and Surgical Center, LLC

Organisation Podiatrist Jackson, MS

Practice location

Address: 1915 Dunbarton Drive, Jackson, MS 39216
Phone: (601) 982-3338
Fax: (601) 982-2253

Authorised official

Name: Bryan Tipton Sullivan
Title: Owner
Phone: (601) 982-3338

Registered specialties

Podiatrist Primary

Podiatric Medicine & Surgery Service Providers Taxonomy 213E00000X Licence 80089 (MS)

Other Podiatrist providers in Mississippi →

Registry record

NPI: 1235209115
Entity type: Organization
NPI issued: 8 Nov 2006
Record last updated: 19 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.